——™ @ DATE (MMIDDIYYYY
ACORD CERTIFICATE OF LIABILITY INSURANCE + /48/2017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Robert Bean
Bean Insurance Agency LLC FHONE Ext), (503) 926-3830 EA, No): (603) 926-0283
151 Winnacunnet Road EMAIL ...bob@beaninsurance .com
P.O. Box 660 INSURER(S) AFFORDING COVERAGE NAIC #
Hampton NH 03843-0660 INSURER A:Rockhill Insurance Company 28053
INSURED INSURERB:Ohio Security Ins Co 24082
EnviroSystems Inc INSURER C:‘Associated Employers Ins Co 11104
1 Lafayette Rd INSURER D:
PO Box 778 INSURER E:
Hampton NH 03843-0778 INSURER F:
COVERAGES CERTIFICATE NUMBER:2017-18 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL|SUBR POLICY EFF_| POLICY EXP
MMIDDIYYYY) | (MM/DDIYYYY)
LTR TYPE OF INSURANCE INSD | wD POLICY NUMBER LIMITS
x | COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
a | |_| cuams.mave | x | occur PAUSES (ee onourtence) | $ 50,000
x ENVP003462-03 6/26/2017 | 6/26/2018 | MED EXP (Any one person) $ 5,000
|_| PERSONAL & ADV INJURY | $ 1,000,000
| GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
| X | Pouicy [| Ser [| Loc PRODUCTS - COMPIOP AGG | $ 2,000,000
OTHER: __ $
| AUTOMOBILE LIABILITY | (fouccdent LS 1,000,000
aL] ANY AUTO SCHEDULED BODILY INJURY (Per person) $
|__| autos AUTOS x BAS56564229 3/1/2017 | 3/1/2018 | BODILY INJURY (Per accident) | $
X | HIRED AUTOS AUTOS (Per accent) $
{> |
BACEE $
| |UMBRELLALIAB | | occuR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED | | RETENTION$ $
WORKERS COMPENSATION, x [ete | 1
ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L. EACH ACCIDENT $ 1,000, 000
c (Mandatory in NH) EXCLUDED? wcec-500-50163161-2016A 10/6/2016 | 10/6/2017 | E.L. DISEASE - EA EMPLOYEE $ 1,000,000
DLSGRISTION OF OPERATIONS below E.L, DISEASE - POLICY LIMIT | $ 1,000,000
A | PROFESSIONAL & POLLUTION x ENVP003462-03 6/26/2017 | 6/26/2018 | EACH INCIDENT $ 1,000,000
RETRO DATE 06/26/1999 Deductible $2,500 AGGREGATE LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES {ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of Nashua, NH is listed as additional insured.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Nashua, NH ACCORDANCE WITHTHE POLICY PROVISIONS.
Risk Mianagement Dept .
229 Main Street
Nashua NH 03061 AUTHORIZED REPRESENTATIVE
,
Bob Bean
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and !ogo are registered marks of ACORD
INS025 19014011
